common sleep disorder Archives - MyMedicPlus

Don’t let the lockdown push you to the brink of insomnia

mymedicplus — Tue, 26 May 2020 12:39:23 +0000

source:- hindustantimes

For most of us, life was on autopilot, with a planned structure. But now, with no need to report to work, most of us are spending nights either working, surfing the internet or watching OTT content

We loved the idea of a work from home scenario, the mere thought of having ample time on our hands, made us ecstatic. But little did we know that this freedom had the potential to mess with our daily routine and most importantly, our sleep cycles. For most of us, life was on autopilot, with a planned structure. But now, with no need to report to work, most of us are spending nights either working, surfing the internet or watching OTT content. Kavita Mungi, mental health counsellor, affirms, she says, “As there is no urgency or timings of attendance, even if one is working from home, it leads to a lethargic state of mind and body. There is no train/ bus to catch early in the morning or anywhere to go to. So, one may just stay awake late at nights binge watching their favourite shows. This, in turn, may result in a disturbing sleep- wake cycle. One has to also watch out for binge eating and drinking which may lead to a disturbing mental as well as physical health situation.”

But what can be done, though, is being aware of, and recognising these changes, and then acting upon them to improve the situation. The virus has not taken away hours from our days. What the virus has done though, is deleted our familiar programs.

Dr Shwetambara Sabharwal, clinical psychologist and relationship counsellor, cautions us, she says, “Let’s not be delusional and trivialise this experience, this is a hard U-turn and has shaken us to the core. We must understand why some of us are finding this newness hard to absorb and then make certain adjustments.”

Sabharwal explains that there are three dimensions to our existence that we need to deploy, all together, to adapt and survive”

1 Body: the body works on oxygen, water, food, sleep, and of course prevention of disease. Recognise its needs and the new reality. Use and nourish your body well, with good breathing techniques, healthy eating, hydration, exercise, sleep, and necessary precautions.

2 Mind: Break down your rigid perceptions of what a day and schedule “must” look like, that productivity is a consequence only of formal office hours, that housework is not work at all, and finally embrace and respect your new reality.

3 Soul: The most valuable hard lesson that we have been compelled to swallow during these times is that we are all weak, vulnerable, conquerable and in that, we have realised that we are one. That realisation is enough for the soul to be nourished. When we feel one with those around us, with nature, we act in ways that help and support our own being.

Tips to deal with an irregular sleep cycle:

1. Plan a sleep-wake schedule that matches your regular work hours

2. Exercise to stay fit and get adequate sleep

3. Eat healthy and at regular intervals

4. Avoid spending unhealthy hours on social media

5. Manage stress by working on it by keeping yourself busy, talking to people close to you or seeking help

The post Don’t let the lockdown push you to the brink of insomnia appeared first on MyMedicPlus.

Some of us have more time to sleep. So why are we so tired?

mymedicplus — Sat, 23 May 2020 17:45:28 +0000

source:- washingtonpost

Since the onset of the coronavirus pandemic, I wake up most days already tired. Coffee is mandatory, and that wasn’t the case before. My husband is more sluggish, too. We have increased responsibility, taking care of our toddler while still working full time from home. It’s also harder for him to fall asleep and harder for me to keep my eyes open in the afternoon.

This pandemic is exhausting, mentally and physically. Our worlds have shifted, and it takes emotional energy to cope with that. Health-care workers are spending long shifts in hospitals and care homes trying to keep patients alive. Other essential workers are pulling overtime in grocery stores, warehouses, fields, production plants and delivery trucks to ensure the country has enough food, toilet paper and face masks. At-home workers are doing their jobs and, in many cases, also caring for and educating children.

But some of us actually have more time to sleep. If we’re working from home, our commutes have been eliminated. We don’t have to get ourselves ready for work and the kids — and their lunches — ready for school. We can sleep in, or perhaps even squeeze in a nap. But with these supposed sleep luxuries at our disposal, it’s still common to feel downright drained. Why?

Quality and quantity of sleep both matter

If you theoretically have more hours to spend sleeping but “are experiencing sleep difficulty, it’s absolutely logical,” says Rebecca Robbins, a postdoctoral fellow and sleep researcher at Harvard Medical School. Though you might be working from home or be in a low-risk category, “the worry of being impacted can loom larger than life on your sleep and mental bandwidth.” The uncertainty of the pandemic, concern for others and ourselves, and the utter lack of control is a perfect storm for insomnia and sleep difficulty, Robbins says.

A study out of Wuhan, China, involving 3,637 participants who were covid-19 free found that the prevalence of insomnia increased significantly along with worsened insomnia symptoms during the outbreak. The main causes included anxiety, depressive symptoms and fear of getting infected, but also economic-related stress, difficulty handling social distance restrictions and changes in daily life.

As we experience repetitive days under duress over a long period of time, we move from acute stress to chronic stress, which takes a toll on the brain, says Gail Saltz, associate professor of psychiatry at New York-Presbyterian Hospital and the Weill Cornell Medical College, and host of the “Personology” podcast. “Chronic stress raises cortisol levels . . . and it can certainly cause you to have more awakenings during the night. It doesn’t matter if you have the time to sleep.”

Finally, “everything we’re doing is new, and [it] takes a lot of energy to do new things,” says Lori Russell-Chapin, a professor of counselor education and co-director of the Center for Collaborative Brain Research at Bradley University in Illinois. The mental and emotional burden of novel experiences — from being hyper-alert while grocery shopping to grieving the loss of a loved one from afar — wears on us.

More hours in bed isn’t always the solution

Although you might have more opportunities to rest during this period, additional time in bed doesn’t necessarily improve your sleep quality. “Your bed should be the place that you crave for sleep,” says Robbins, co-author of “Sleep for Success!” If you allow yourself to lie there and toss and turn, “you can actually start to develop insomnia, because the bed starts to be that stressful place . . . as opposed to where you fall into peaceful slumber.”

Saltz says oversleeping can lead to problems, too, such as impaired cognitive function. “Oversleeping is likely to make you feel ‘less sharp-minded’ and ‘blah’ in terms of mood,” she writes via email. Getting seven to nine hours of sleep each night on a consistent schedule is recommended, not logging 12 hours just because you can.

It’s certainly tempting to stay up late when you don’t have to be in the office early, or snooze for a couple of hours midday because you’re at home. But with those habits, “we’re messing around with our natural circadian rhythms,” Russell-Chapin says. “If you nap in the daytime, you’re not telling your body that [you’re] supposed to nap at night for eight hours.”

Steps to improving your sleep quality

The tenets of good sleep hygiene — such as getting some exposure to sunlight and limiting caffeine intake — shouldn’t be overlooked. Setting and sticking to a sleep schedule should be a priority, because our circadian rhythm acts as a well-oiled machine, Robbins says. “Commit to keeping your bed and rising time as close to the same time Monday to Monday as possible,” she writes via email. “If you are a true night owl and prefer late bedtimes, find a schedule that you can keep throughout the workweek and operate on your preferred rhythm.”

But keeping a consistent schedule is only part of the solution. During the pandemic, it’s common to “lie down and your mind is still going because there’s just no downtime,” says Alyza Berman, founder and clinical director of the Berman Center, which offers mental health treatment in Atlanta. You might be thinking about how you forgot to buy hand sanitizer at the store, whether you have enough toilet paper left or how your nurse friend is coping with being on the front lines.

To improve your sleep quality, you have to calm that brain activity, something Robbins says she didn’t learn to do until she went to a meditation retreat. “What we have to do to fall asleep is quiet our mind,” she says, “and that’s exactly what you’re doing when you’re meditating.”

But you don’t need a retreat or even an app to get started. The one tool Robbins suggests? A five-minute timer. Before lying in bed, find a quiet place. Sitting comfortably with your eyes closed, try “calming the mind, breathing heavily and deeply, and moving away from stressors in your environment,” she says. As thoughts enter the mind, “acknowledge them and then come back to the breath, come back to something that’s tangible in the present.” The goal is to slip away from stress and prepare your brain and body for sleep. Robbins says that those who meditate regularly experience better-quality sleep, because they fall asleep faster and into a deeper sleep.

Both Robbins and Saltz agree that meditation takes practice, so you’re not likely to see life-changing results the first time you try it. But sticking to some meditation for even five days could help you reap the rewards of better, deeper sleep, Robbins says.

Transitioning as society reopens

Although it’s unlikely that we’ll return to our lives as they once were — at least for some time — some workplaces are beginning to reopen across the nation. We might see different schedules or more opportunities to work from home, but some of us will go back to a set schedule that might be a difficult jump from our current state. If you have enjoyed not having to commute or put in long hours away from home, how can you ready yourself for this shift?

Robbins suggests preparing for your transition as you would an upcoming trip. If you were heading to London, for example, “in the week leading up to that trip, you’d be starting to switch your calendar a little bit closer to your destination.” She says to take small steps each night, such as going to bed 15 minutes earlier, to move in the direction of your new schedule. These incremental adjustments give your body and mind time to adapt.

Besides our sleep schedules, there can be additional stress and exhaustion as we reenter the world. From worrying about whether we’ll be infected to wondering whether we’ll still have a job, some fear of the unknown remains — and that, as we know, is tiresome.

Digging into the “what-ifs” usually causes anxiety, Saltz says, which expends a lot of energy. “We’re not going to be able to get uncertainty to go away.” The best approach for dealing with uncertainty, Saltz says, is to first pick a trustworthy source for information, such as the Centers for Disease Control and Prevention (cdc.gov) or the World Health Organization (who.int), to help you make decisions such as whether to wear a mask. Then, allow the remaining uncertainty to sit with you, rather than fight with it or run away from it. “The only way you can coexist with [uncertainty] is to sort of let it float like a cloud and be there. It won’t be in your front windshield. It’ll be off to the side . . . so you can drive.”

Your Life at Home

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How to Sleep When the World Is Falling Apart

mymedicplus — Fri, 22 May 2020 14:37:42 +0000

source:- wired.com

It’s not easy to relax in the middle of the Covid-19 pandemic. But there are some simple tips and techniques that can help you get some shut-eye.

LIFE IN THE Covid-19 pandemic has taken on some unpleasant and unexpected contours. Time has lost all meaning. Dreams have become assailingly vivid. That is, if you’re able to sleep at all, which many people cannot. At least, not as well as they did before it felt like everything was unraveling, all of the time, with no end in sight.

“I am seeing a significant spike in insomnia at this time during the pandemic,” says Lisa Medalie, a behavioral sleep medicine specialist at the University of Chicago.

It might be useful to nail down our terms here. Insomnia isn’t just staying up late. It’s the inability to sleep—or to fall back asleep if you wake in the middle of the night—with no obvious impediments to explain it. Implicit in the definition, too, is that the deprivation negatively impacts your ability to function the next day. It’s acute when it lasts a few days or weeks; if it extends longer than a month, it’s considered chronic.

If this sounds like you, know first that you’re going through the same thing as a lot of people. And also know there are a few simple strategies you can deploy to get yourself back on track.

Who Needs Sleep?

It is extremely understandable if you have cut yourself some slack during these sheltered-in-place times. Maybe your diet has gone a little snack-heavy. Maybe you shifted your work hours to make way for childcare or self-care. Maybe you stopped flossing. Only natural. But sleep is something worth preserving—even though that’s harder than it may sound.

“During times of increased stress, sleep is often the first biological system to malfunction,” says Candice Alfano, director of the University of Houston’s Sleep and Anxiety Center. A pandemic is stressful like magma is hot. In a recent online survey conducted by Alfano and her research team, the rate of respondents reporting “severe to very severe problems” either falling or staying asleep was double what they normally see.

That tossing and turning has real health implications. As neuroscientist and sleep expert Matthew Walker detailed in a 2019 TED Talk, sleep deprivation makes your brain slower, weakens your immune system, and increases the likelihood of all kinds of mental and physical woes as you age. “Sleep loss will leak down into every nook and cranny of your physiology,” Walker said in his viral presentation. “Sleep, unfortunately, is not an optional lifestyle luxury. Sleep is a nonnegotiable biological necessity. It is your life support system.”

Unfortunately, life amid Covid-19 disrupts that sleep in any number of ways. There’s the anxiety, sure, not just about the disease itself but about financial security, childcare, and all the other ancillary effects of a society in suspended animation. “If you’re not tackling those problems head-on during the day, then when it’s just you and your brain at night and there’s no distractions, all of those problems, all those worries, all those stressers are going to come bubbling to the surface,” says Medalie. “The thoughts are going to produce emotional responses, the emotional responses are going to produce more thoughts, and the realization that time has passed and you’re not sleeping produces anxiety.”

It gets worse. “The relationship actually runs in both directions,” says Alfano. “Even during times of low stress, sleep loss elevates next-day anxiety, potentially creating a vicious cycle.”

While stress contributes greatly to sleep woes, it’s not the only factor in play. Staying mostly at home makes for a more sedentary lifestyle than your body might be accustomed to, which can make falling asleep harder. You may be looking at your screen even more than usual, pulling to refresh for the latest Covid-19 tolls or mind-smoothing TikTok loops late into the night. While you do, the blue-spectrum light emanating from your phone tells your brain to stop producing melatonin, the hormone that regulates your sleep-wake cycle, also known as the circadian rhythm.

And while bedtime gets much of the focus when it comes to sleep problems, a morning without routine—there’s no office to report to, after all—can be just as detrimental. “A lot of people don’t realize that the wake-up time and getting out of bed and exposure to light is probably the most important thing that regulates our circadian rhythm,” says Jason Ong, a neurologist who focuses on sleep medicine at Northwestern University, referring to the biological process. “Your brain is confused about what time zone it’s supposed to be in.”

The circumstances wrought by Covid-19, in other words, seem almost specifically engineered to interfere with your sleep cycles. Fortunately, there’s plenty you can do to reclaim your shut-eye.

Night Sweats

Let’s start with that looming existential dread, since it’s probably the most pandemic-specific contributor to your tossing and turning. The bad news is, you’re probably stuck with it, at least until a vaccine arrives.

You can still take steps to manage it, though, especially as night falls. And it starts with not doing anything at all. “Make sure you have a scheduled hour of ‘me time,’” particularly if you’re sheltering in place with others,” says Medalie. “Everybody needs at least one hour by themselves.”

How you spend that time is up to you. But as you get closer to bedtime, make sure it’s genuinely relaxing. ”Instead of watching or reading the news—most content is repetitive anyway—engage in quiet, calming activities under dim lighting, such as reading, talking with family or friends, or listening to music,” says Alfano.

This all might sound easier said than done. But small adjustments can make a big difference. Don’t bring your smartphone into the bedroom, for starters, or tablets or laptops or any screens at all. If you have a TV in there, consider jettisoning it. Alfanso suggests putting all your charging cords in the kitchen, and setting a reminder for an hour before bedtime to plug in all your electronics and bid them adieu until the morning. Old-school alarm clocks still exist! And some even have built-in light functions designed to help you sleep and wake up on a regular schedule. (WIRED recommends the Homelabs Sunrise Alarm Clock, but you’ve got no shortage of options.)

Northwestern’s Ong also researches how mindfulness techniques can improve sleep, especially for those with chronic insomnia. “It can be a potential tool to help reduce that vigilance, give your brain some signals that it doesn’t need to go into that fight-or-flight mode, or that if it does, here are some tools to help decompress, so that you have a more fair chance for your sleep system to help you fall asleep and stay asleep,” he says.

A simple way to start is to think of yourself as a trainspotter. (Presumably not one from the 1996 Danny Boyle film.) Much like a trainspotter observes railcars passing by from a distance, try to observe what’s happening in your mind without directly engaging with it. If you do find yourself boarding at some point, just get off at the next station. “As you do that, you will start to train yourself that it’s OK to focus on this present moment,” says Ong.

Apps also offer an entry point to anxiety-quashing meditation, although that complicates the whole “remove the phone from the bedroom” scenario. WIRED contributors have had some success with Calm, which offers a range of soothing sessions. Even Swiss Army workout app Peloton has a sleep meditation section, including at least one class specifically designed for the 3 am wake-up.

A to Zzzzz

Getting good sleep involves more than just clearing your head. The experts WIRED spoke with all agree that clearing your bedroom is just as important. “The bedroom should just be a bedroom. Just a room for your bed, and maybe your dresser, and nothing else in there,” says Medalie. “Sleep and sex are the only two things that should happen in the bedroom.”

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